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Monday, January 31, 2011

Any cause which results in hearing loss can produce ringing sounds in ear. So if we can improve hearing with any modality (Surgery, Medicine or hearing aid), then it should result in diminished ringing sensation.

I need to see your audiometry report and scans to tell you what best can be done for you. You can send the same via email or meet in my clinic with prior appointment.

with Best Regards,

Dr. Ajay Jain

30 Jan, 2011

Dear Dr. Ajay Jain,

Medical Guide Ad Response

Sender Details and Message

City.

:

Bronshoj

Country

:

Denmark

Message/Query

Hi,
i am Razib.
my nationality from bangladesh.
i live in denmark As a IT specialist.
i have much more hearing problem from 2 months.its coming too much sound from
my both of the ears.
now suddenly it has reduce my hearing too much.i can only hear from very very near to me.
and when i walk,during that time,it comes walking sound in my ears.

i visited denmark doctors,they have scaned my brain but every thing is ok.
even they could see any infection in my ear.
they can not guess why i m not hearing,and why is the sound.but now a days,im too much sick for
the sound in the ear.
i would like to come and get treatment from your hospital if you help me to overcome my ear problem.

Saturday, January 22, 2011

Steam can be taken by either the convenient Steamer or from the boiling water on a heater. The second option is dangerous especially with kids.

It's not necessary to keep the face too close to container. Even a chair close to the steamer is enough. You can leave the steamer on and do your table work.

Should I put something into boiling water like vicks or karvol?

Steam is a pure form of water. Water evaporates after boiling and when it condenses into air passage, then it leaves moisture there. This moisture helps moving dried up small hairs which ultimately moves the mucus. Putting these things may increase the pleasant experience like smell but as such they do not have an additional function and may not be necessary to use.

Can I take Nebulizer instead of steam?

Nebulizer is no substitute of steam. It has different function which can not be done by steam either.
Nebulizer is for lungs whereas steam is both for lungs and nose. Nebulizer is way of delivering drungs for local action in lungs while steam delivers moisture both to lungs and nose.

Some viruses like Rhinovirus which causes common cold are susceptible to heat. So taking steam helps in eliminating such viruses.

Wednesday, January 12, 2011

I am of the firm opinion that apart from good surgery, it's the faith of the patient in doctor that heals the patient's suffering. Sometimes I was not happy with the surgery but patient's longanimity and faith of him in me that he is happy with the outcome. At other times, I have done a wonderful job surgically but still patient is not happy. So TRUST is the key issue for good outcome.

There are instances where I had to revise my cases with revision surgery. I even offered the patient that someone else might do the same surgery whom I think is better than myself yet patient insisted me only to do the job. Fortunately results were satisfying.

Those patients who have happy-go-attitude towards life do very well after surgery and those are emotional kind, have unrealistic expectations towards life do worst despite surgeon's best job.

Sunday, January 9, 2011

The case was operated upon by right infraorbital incision, right sublabial incision and right FESS to marsupialize the cyst which drained into right nose. the patient is doing fine in postoperative period with slight diplopia in certain eye movements.

This case was unusual in that here the boy presented at the age of 33 years with a history of left side nasal bleed for last one years. To prove it to be a case of Angiofibroma, I took biopsy under local anesthesia. luckily, since the tumour mass was occluding the choanea, it did not bleed into oropharynx. Biopsy showed thick angiod element with final inference of benign vascular growth. DSA showed it to be getting supply from both internal maxillary artery and left ascending pharyngeal artery which were embolized by PVA particle.

The case was operated upon by team of Dr. Atul Jain, Dr. Ajay Jain and Dr. Poonam Gautam at Pushpanjali Crosslay Hospital. A Transpalatal approach was used as shown in first figure. It bled a lot but no transfusion was required. The final histopathological examination of specimen confirmed it to be Angiofibroma.

Tuesday, January 4, 2011

Haemostasis during Tonsillectomy is an extremely important step and different surgeons have different preference for securing it. Some like suturing the bleeder which may be technically challenging at times or some like diathermy. Diathermy may be unipolar or bipolar.

Recently I did a paediatric tonsillectomy where I was comfortable with sutures and an adult tonsillectomy where sutures did not work and bleeding could be secured by bipolar cautery only. The apparent reason could be the larger and deeper tonsillar bed in adults where its difficult to secure sutures and because of too much fibrosis, it bleeds a lot.

In my opinion, suturing is best method with vicryl provided you can secure the knots at right place otherwise bipolar cautery is good. Radio-frequency is an excellent substitute for cautery and of late coblation has come. The adverse effect of using diathermy (cautery, radio-frequency or coblation) is increased postoperative pain and long term chances of developing neuralgic pain (Acquired Eagle's Syndrome).